title: Persistent middle cerebral artery occlusion associated with lower body temperature on admission.
abstract: BACKGROUND
  Low body temperature is considered neuroprotective in ischemic stroke, yet some studies suggest that low body temperature may also inhibit clot lysis and recanalization. We hypothesized that low body temperature was associated with persistent proximal middle cerebral artery (MCA) occlusion in patients with acute ischemic stroke presenting with symptoms of proximal MCA occlusion, suggesting a possible detrimental effect of low body temperature on recanalization.
  
  
  METHODS
  All patients with acute ischemic stroke admitted to our Stroke Unit between February 2006 and August 2012 were prospectively registered in a database. Computed tomography (CT) angiography was performed in patients admitted <6 hours after stroke onset. Based on presenting symptoms, patients were classified according to the Oxford Community Stroke Project classification (OCSP). Patients with symptomatic proximal MCA occlusion were compared to patients with total anterior circulation infarct (TACI) without MCA occlusion on CT angiography.
  
  
  RESULTS
  During the study period, 384 patients with acute ischemic stroke were examined with CT angiography. A total of 79 patients had proximal MCA occlusion and 31 patients had TACI without MCA occlusion. Median admission body temperatures were lower in patients with MCA occlusion compared to patients without occlusion (36.3°C versus 36.7°C, P = 0.027). Admission body temperature <36.5°C was independently associated with persistent MCA occlusion when adjusted for confounders in multivariate analyses (odds ratio 3.7, P = 0.007).
  
  
  CONCLUSIONS
  Our study showed that low body temperature on admission was associated with persistent proximal MCA occlusion. These results may support a possible detrimental effect of low body temperature on clot lysis and recanalization.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway. echr@helse-bergen.no
authors.forename: Christopher Elnan
authors.initials: CE
authors.lastname: Kvistad
authors.forename: Halvor
authors.initials: H
authors.lastname: Øygarden
authors.forename: Lars
authors.initials: L
authors.lastname: Thomassen
authors.forename: Ulrike
authors.initials: U
authors.lastname: Waje-Andreassen
authors.forename: Halvor
authors.initials: H
authors.lastname: Naess
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001833:Body Temperature Regulation; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway; D016017:Odds Ratio; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers
keywords: MCA occlusion; body temperature; clot lysis; ischemic stroke